Hepatitis B Vaccination the HBV vaccination must be offered after the employee has received training and within 10 working days of job assignment At no cost Provided by PLHCP According to US Public Health Service most current recommendations “Immunization of Health Care Workers: Recommendations of ACIP and HICPAC,” MMWR, Vol. 46, No. RR-18

HBV Vaccination Employees who do not take the shots must sign a declination statement Highly recommended Few contraindications Three-shot series—titer 1-2 months after last shot No booster currently recommended Each person must have a health care professional's written opinion A copy must be provided to the employee within 15 days of completion of the evaluation An employee can decline now, take the shots later

Written Opinion Each person must have a health care professional's written opinion for hepatitis B vaccination A copy must be provided to the employee within 15 days of completion of the evaluation

Post-Exposure Follow-up After exposure incident Stick or cut Splash Non-intact skin exposure At no cost Begin ASAP after exposure incident Report exposure incident to your supervisor or designated personnel immediately

Post-Exposure Follow-up Investigation of the incident ID source individual, obtain consent, and test their blood to determine HBV, HCV, and HIV infectivity ASAP Results of source individual's test given to exposed person Obtain and test exposed person's blood for HBV, HCV, and HIV serological status

Post-Exposure Follow-up Post-exposure prophylaxis as indicated by CDC “Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis” June 29, 2001, Vol 50, No. RR-11 “Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis,” September 30, 2005, Vol 54, RR-09 Counseling and Evaluation of reported illnesses

Written Opinion The employee must be provided a copy of the Health Care Professional's Written Opinion for Post-Exposure Follow-up within 15 days of completion of the evaluation

Labels Containers with contaminated items Can substitute red

Training For all employees listed in the Exposure Determination At no cost to employees During working hours At the time of initial assignment Annually--within 1 year of last training date Must be opportunity for interactive questions and answers Train employees on adopted safer needle devices before implementation

Training Five Easy Questions What is universal precautions? What do you do when there is a blood spill? Personal protection Clean-up and disposal procedures Disinfection (hazard communication applies) What do you do with contaminated sharps and laundry? Have you been offered the HBV vaccination free of charge? Where is the Exposure Control Plan?

Additional Training Copy of the BBP standard, 29 CFR 1910.1030, must be accessible to you Explanation of methods of recognizing tasks that may involve exposure to blood and/or body fluids Information on types, use, location, removal, handling, decontamination, and disposal of ppe Basis of selection of ppe Actions to take and persons to contact in a bloodborne emergency that you do not know how to handle Procedure to follow if exposure incident occurs Opportunity for interactive Q & A

Records Medical records Name and social security number HBV vaccination status Results of exposure incident follow-up Health care professional's written opinions Info provided to health care professional Confidential

Records Training Dates Contents Names and qualifications of trainers Names and titles of persons attending

Records Sharps Injury Log Per the Tennessee Sharps Injury Prevention law Keep a log of all sharps injuries with Type and brand of device involved in the incident Department or work area where the incident occurred Explanation of how the incident occurred

Resources www.osha.gov www.tennessee.gov/labor-wfd/tosha www.cdc.gov www.cdc.gov/niosh Memphis Office 901-543-7259 Jackson Office 701-423-5641 Nashville Office 615-741-2793 1-800-249-8510 Knoxville Office 865-594-6180 Kingsport Office 423-224-2042 Chattanooga 423-634-6424 Consultative Services 1-800-325-9901